Preoperative Care

Latest Issue of OR Manager
June 2019

OR leaders see benefits of briefer NPO period

Though long fasting before a surgical procedure is tied to increased patient risks, the outdated guideline of NPO after midnight continues to be practiced by many healthcare organizations. In 1999, the American Society of Anesthesiologists (ASA) revised their fasting guidelines to clear liquids up to 2 hours before surgery and…

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By: Judith M. Mathias, MA, RN
May 17, 2019
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Adherence to ERAS protocols associated with fewer postop complications

Editor's Note An increased in adherence to Enhanced Recovery after Surgery (ERAS) protocols was associated with a decrease in postoperative complications in this study. Of 2,084 patients analyzed, 566 had moderate to severe postoperative complications. The number of patients with moderate to severe complications was lower in the ERAS group…

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By: Judy Mathias
May 13, 2019
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Patient, surgeon outcomes reporting app helps predict success of ventral hernia repair

Editor's Note Researchers have developed an online app that patients and surgeons can use to guide preoperative planning and provide predictive data for how a patient’s ventral hernia repair will turn out. The basis of the app is a tool named the “Outcomes Reporting App for CLinical and Patient Engagement”…

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By: Judy Mathias
May 8, 2019
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Intervention to reduce low-value preop tests before cataract surgery

Editor's Note Reducing low-value testing before cataract surgery was associated with cost savings for financially capitated healthcare systems, but it was also associated with losses for fee-for-service healthcare systems, which could be a barrier to eliminating low-value care, this study finds. Of 1,054 patients (469 intervention, 585 controls) included in…

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By: Judy Mathias
May 7, 2019
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Preop functional status predicts total hip outcomes

Editor's Note Compared with preoperative independent functional status, preoperative dependent functional status was independently associated with worse outcomes after primary total hip arthroplasty in this study. Of 43,179 patients analyzed, those who were less able to care for themselves: were 2 to 3 times more likely to have surgical complications…

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By: Judy Mathias
April 23, 2019
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Factors linked to, lessons learned from reduced mortality during military conflicts

Editor's Note The increased use of tourniquets, blood transfusions, and reduced time to surgical treatment (ie, within 1 hour) were the main factors that reduced mortality 44.2% during military conflicts in Afghanistan and Iraq, this study finds. From October 2001 through December 2017, survival increase three-fold among the most critically…

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By: Judy Mathias
April 1, 2019
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Long-term opioid use in family members linked to persistent postop use in adolescents, young adults

Editor's Note Long-term opioid use among family members was associated with persistent postoperative opioid use in opioid-naïve adolescents and young adults and should be screened for preoperatively, this study finds. Of 346,251 opioid-naïve patients aged 13 to 21 years having common surgical and dental procedures, persistent opioid use occurred in…

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By: Judy Mathias
March 4, 2019
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Surgical transfer unit allows patients to bypass ED

There are few things more disheartening for patients than having to board in the emergency department (ED) for long periods while waiting for a bed. ED boarding can also delay treatment and adds to overcrowding and backups. Erlanger Health System, based in Chattanooga, Tennessee, decided to tackle this problem head…

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By: Catherine Spader, RN
February 20, 2019
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Effect of routine preop urine screening on postop outcomes

Editor's Note Antimicrobial treatment of asymptomatic organisms identified in preoperative urine cultures was not associated with reductions in the risk for postoperative infections, including urinary tract infections (UTIs) and surgical site infections (SSIs), this study finds. In this analysis of 68,265 patients in 109 Veterans Affairs hospitals who had cardiac,…

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By: Judy Mathias
January 2, 2019
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Effect of prehabilitation program on abdominal surgery patients

Editor's Note Colectomy patients participating in a preoperative prehabilitation program had positive physiologic effects and experienced fewer complications, this study finds. The prehabilitation program−Michigan Surgical and Health Optimization Program (MSHOP)−engages patients in four activities before surgery: Physical activity, pulmonary rehabilitation, nutritional optimization, and stress reduction. For the study, patients were…

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By: Judy Mathias
October 30, 2018
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